PERSONALIZATION OF INTENSIVE NON-SURGICAL TREATMENT IN CHILDREN WITH SPLEEN INJURY
Abstract
Introduction. The main directions of intensive care in non-surgical treatment in children with trauma of the abdominal cavity organs are relevant and unresolved problems. The purpose of the study was to evaluate the effectiveness of the proposed infusion, analgesic and hemostatic therapy in non-operative treatment tactics in the first 24 hours after admission to the hospital in children with isolated spleen injury. Material and methods. 28 patients, from 6 to 12 years old, with trauma of the abdominal organs, who were treated at the Clinic for Pediatric Surgery. N.L. Kushcha on the basis of the Republican Children’s Clinical Hospital in Donetsk from 2014– 2023. The assessment of the severity and prognosis of mechanical injury was carried out on the basis of the pediatric trauma severity scale. Results. In the first 6 hours from the moment of admission to the hospital in patients with isolated blunt trauma, rupture of the spleen parenchyma, the severity of homeostasis disturbances corresponded to an average severe condition, characterized by moderate severe abdominal pain syndrome, class 1 blood loss (<15% BCC). Conclusion. The use on the first day of non-surgical treatment of a ketamine solution with infusion therapy with Ringer’s solution (10 ml/kg/hour) with a transition of 5 ml/kg/hour without the use of blood products is optimal for this group of patients. Hemostatic therapy with tranexamic acid is not accompanied by adverse reactions from the patient’s body associated with the pharmacodynamic effect of the drug.
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